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Modalities > Massage > Flashcards

Massage Flashcards

1
Q

Massage Precautions

A 
Hematomas
non-union fractures
herniated discs
debilitated patients
malignancies
conditions with collagen weakening
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2
Q

Massage Contraindications

A 
When increased circulation is not desired
severe disease / distress
contagious skin disease
over foreign bodies or sharp bony prominences
Acute Conditions
Areas of decreased sensation
over recent surgery
systemic edema
areas of active bone growth
tuberculosis
pregnancy
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3
Q

Massage Indications

A 
Pain
Edema
Trigger Point
Spasm
Contracted Tissue
inefficiencies of circulation
Specific, or general relaxation
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4
Q

What are the general principles regarding strokes?

A 
work broad & light to specific & deep.
 mold hands to pt body
deep pressure: distal to proximal
address entire length of muscle
minimize interruptions
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5
Q

What are the Principles regarding massage?

A

Direction (linear, cross-fiber, distal, proximal)
Duration (take adequate time time to achieve goal)
Pressure (varies based on intent, body region, pathology, and patient tolerance)
Rate & Rhythm (should be purposeful and consistent)

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6
Q

Basic Massage Strokes

learned in class

A

Effleurage, petrissage & compression, friction, jostling, tapotement, trigger point technique, myofascial release

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7
Q

Effleurage

A

superficial - relaxing, calming effect
deep - reflex and mechanical effects

Used for information gathering. calming / focusing. warming of superficial tissues.

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8
Q

Petrissage

A

Intermittent kneading (may be unilateral, bilateral, or digital)

Increases circulation
softens and lengthens tissue

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9
Q

Friction

A

sustained pressure with movement

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10
Q

Jostling

A

rhythmic shaking of tissue or limb
decreases muscle guarding
relaxing

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11
Q

Tapotement

A

hacking, beating, gorilla punching, chopping, slapping

excitatory

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12
Q

What are the considerations for draping?

A

only expose area that you will be treating. parts not treated should be covered by a towel or a sheet

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13
Q

What is a trigger point?

A

focus of hypersensistivity in a tissue, that, when compressed, is locally tender and, if sufficiently hypersensitive, give rise to referred pain and tenderness, and sometimes to referred autonomic phenomena and distortion of proprioception

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14
Q

What are the characteristics of triggerpoints?

A

consistent referred pain patter upon compression.
Local twitch response elicited by palpation
possible restriction in ROM
muscle weakness with no appreciable atrophy possible autonomic phenomena including vasomotor and pliomotor responses

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15
Q

Active Trigger Points

A

always tender, produce referred pain
associated muscle may be weak and present with decreased motion/flexibility
when palpated, present with localized twitch response

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16
Q

Latent Trigger Points

A

painful only when palpated,

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17
Q

TrP Causes

A

fractures, sprains, dislocations, muscle impact injuries, stress from excessive, or unusual exercise, articular dysfunction, overload on the muscle from prolonged stationary posture or prolonged immobilization in a shortened position
nerve compression

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18
Q

What are the indications of a JOBST Pump?

A

Edema

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19
Q

What are the contraindications of a JOBST pump?

A

Thrombophlebitis, cellulitis, severe congestive heart failure

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20
Q

What is the treatment time of a JOBST pump?

A

10min-4 hours 1-2 times per day

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21
Q

What is the Duty Booty of the JOBST pump?

A

45 Sec on / 15 sec off to 3min on / 1 min off

22
Q

What should the pressures never exceed (in arm, leg, and overall)

A

Should never exceed 90-120mmHG

Arm - 50mmHG
Leg 60-70mmHG

23
Q

Indications for Cyriax (friction massage)

A

Promote healing of connective and contractile tissue
To retain or regain mobility
Pain Modulation

24
Q

Contraindications for Cyriax (friction massage)

A

Acute inflammation
Hematoma
Conditions that increase bleeding (hemophilia, anti-coagulants, steroids)
Debilitated/open skin

25
Q

What are the general effects of massage CV system

A

Circulation
Dilation of vessels via local reflex
increase SV by venous return
decrease DVT by decrease in viscosity & hematocrit
edema - increases lymph flow via mechanical pressure

26
Q

What are the general effects of massage on connective tissue

A

Decreases pain and improves tissue mobility

27
Q

What are the general effects of massage on muscle tissue and nervous system?

A

in muscle tissue, it decreases spasm, and decreases muscle hypertension. In the nervous system, it decreases pain via gateway theory of pain and also an increase in opiate production.

28
Q

List the types of swelling in the body and describe the physiological effects behind why they occur.

A

Joint Swelling
cause by pressure of blood and joint fluid in a joint as a result of tearing of tissues an blood vessels or synovial irritation
Has appearance and feel of a water balloon.

Interstitial Swelling
caused by an increase of osmotic pressure in tissues which attracts water and creates swelling
has the appearance of “silly putty” when involved tissue is pressed

Cell Swelling
cells near death and unable to control the cell membrance can attract water and swell
Congestive heart failure
heart that is so stretched, it does not produce a large contractile force, ~10% left in heart → when it fills again, decreased CO due to more stretch from remaining blood left in the heart. easiest sign → swelling in all extremities.

Venous insufficiency

Kidney Failure
can’t filter out waste, so excess salt is left in the blood, which creates a gradiant, and swelling occurs.

29
Q

What is the purpose of friction massage?

A

to mobilize adherent tissue
reduce/mobilize trigger points
increase local circulation
decrease pain

30
Q

Types of friction massage (4)

A

cyriax, linear/parallel, circular friction, and cross-fiber friction

31
Q

What is cross fiber friction massage?

A

deep friction applied perpendicular to the fibers

32
Q

What is parallel friction massage?

A

deep friction applied in the same direction of the fibers

33
Q

What is circular friction massage?

A

repeated circular motion, distal to proximal consideration

34
Q

What is Deep transverse friction massage? (DTFM) aka Cyriax

A

Technique used to reduce adhesions and make scar tissue more mobile in sub-acute and chronic inflammatory stages by realigning normal soft tissue fibers

35
Q

What are the effects of DTFM? (4)

A

mechanical - mobilization of damaged tissue over a small area and elongation of fibers

Physiological - localized edema

Histological - prevents or slows scar formation and stimulates collagen orientation along lines of stress

Neurological - pain inhibition via stimulation of mechanoreceptors
`

36
Q

What should you do before and after using a JOBST pump?

A

perform volumetric or circumferential measurements to determine efficiency.

37
Q

What are the factors that can cause edema?

A
  1. high capillary pressure (blood pressure or blood clots)
  2. low blood plasma (starvation, alcoholism, hypothyroidism)
  3. lymphatic blockage (post mastectomy, elephantitis)
  4. increased capillary porosity releases electrolytes and proteins (burns, allergic reactions).
38
Q

Pitting Edema

A

the maintenance of a depression for 5-30 seconds following physical pressure on an area. caused by fluid being expressed from the interstitial area by the pressure and slowly returning as the pressure is removed.

39
Q

Non-pitting Edema

A

swollen tissue which the fluids cannot be displaced from. may be due to swelling of individual cells (secondary to trauma or poor nutrition) or due to coagulation of tissue or capture of fluids by a gel-like substance which prevents the fluids from being expressed.

40
Q

Lymphedema (define primary and secondary)

A
  1. Primary - congenital blockage of lymph channels. Edema caused by obstruction of the lymph channels. could be to the extent that they can’t drain
  2. Secondary:
    inflammation - pressure of swelling blocks fluids
    Trauma - causing inflammation (scar tissue can cause blockage)
    Neoplasm - growth that is space occupying (prevents /blocks fluid movement)
    Irradiation - increase dose of x-ray can cause damage of tissue
41
Q

Treatment of Edema

A

Elevation, muscular contraction, compression, elastic compression, massage, intermittent compression (JOBST)

42
Q

What are the three effects of Cyriax Massage?

A
  1. Traumatic Hyperemia
  2. mobilize adherent tissues
  3. Stimulate mechanoreceptors
43
Q

What are the key points of Cyriax Friction Massage?

A
  1. Friction is applied to an exact location
  2. No movement between the fingers and skin
  3. Friction is applied in transverse direction
  4. Friction must have adequate amplitude to move completely over structure
  5. Friction must be applied at a depth sufficient enough to reach the target structure
44
Q

What are the three function of the lymphatic system?

A
  1. Remove excess fluids from tiissue
  2. Absorption of fatty acids anf subsequent transport of fat to the circulatory system
  3. production of immune cells
45
Q

Cyriax Massage position for Muscles

A

supported in a position of relaxation or reduced muscle tone

46
Q

Cyriax Massage position for tendons

A

must be at end ROM

47
Q

Cyriax Massage positions for ligaments

A

taut, as far as the ROM allows

48
Q

Treatment protocol cyriax

A

initial treatment is 5-6min. 1st 1-2 min pt may feel pain, but will subside. once it does, increase pressure, check every 1-2min and increase.

49
Q

Trigger point pressure release

A

gentle digital pressure, aim to reduce ischemic effect to the injured tissue. One finger palpating the TrP while the muscle is passively lengthened to the point of resistance. At tissue resistance pressure on TrP is slowly increase

50
Q

Digital Compression

A

should be applied to one point for a prolonged period and pressure released with resolution of pain.

Modalities (15 decks)

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